Doctors limit use of flu swab tests

YORK, Pa. — As influenza claims 65 lives in Pennsylvania so far this season, many concerned parents with sick kids may want to get their children tested for the virus.

Some medical experts say the time for the flu swab test has come and gone.

People suffering from symptoms of fever, muscle aches and cough may seek relief, but those expecting a swab test from their doctor to determine if they have the flu, probably won’t get one.

At the height of flu season, the familiar flu swab test for patients may be on its way out.

Health Bureau for the City of York medical director Dr. Matt Howie said "we’re not recommending it be done in outpatient facilities at this point, but folks who are being admitted to the hospital or are more sick from the illness. Actually it’s a very useful test, because it helps guide therapy in that setting. In the outpatient setting, when you’re going to your doctor’s office for urgent care, it really should be a clinical decision at this point."

Doctors say there is a short window of time to do a swab test from the first sign of symptoms to the effectiveness of the medication Tamiflu.

"It's a 72-hour window, getting the test back in 72 hours is actually problematic, so the recommendation is once you know the flu is in the community, is to get a clinical evaluation done. Based on that, decide whether you treat or not," Howie said.

There are other methods doctors are using instead of a swab to determine if a patient has the flu.

"You want to take a good history as a clinician. You want to do your exam, based on that, duration of symptoms, severity of symptoms, age of patient, and other factors, determine whether Tamiflu is appropriate or not to intervene," Howie said.

While some patients who don’t receive the test may believe there’s currently a swab shortage, it's the usefulness of the test itself that may be short-lived this flu season.

"The shortage of it is a relative term. It’s become very common to do, but I would say it’s one of those tests that is potentially overused," Howie said.

"It's somewhat limited in utility. I don’t think it adds a whole lot. A good clinician can do a good exam, a good history and be pretty clear on what’s going on, and help guide the therapy from there," Howie added.

Swab testing has its time and place this flu season.

Doctors say testing tends to be more effective in the fall, earlier in the season, to determine when it hits and what strain.

At this point in the season, many doctors and hospitals are limiting its use.